Summary Congenital cystic adenomatoid malformation (CCAM) is a rare abnormality of lung development. It was classified into 5 types by Stocker in 2002 and is also known under the name of congenital pulmonary airway malformation (CPAM). Cases are typically identified prenatally by routine ultrasonography screening. CCAM may present in the older child and adult as an incidental finding. The case presented is of a 21-year-old male patient who suffered from pulmonary infections with a recurrent productive cough 3-4 times the last 4 years. CT scanning of the thorax showed multiple cystic lesions in the right middle and lower lobes. The areas with the lesions were resected. The macroscopic and histological findings were typical for congenital cystic adenomatoid malformation type 2, which was the final diagnosis. Clinical presentations and prognosis depend on the type of lesion and its sequelae. The diagnosis is confirmed histologically.

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The hormonal regulation of haemostasis is a problem which has not received much attention. The data concerning the influence of hormones from the hypothalamic-pituitary-thyroid axis are scarce, contradictory and based mainly on clinical observations. The objective of the current research is to study the influence of the Thyrotropin releasing hormone (TRH), Thyroid stimulating hormone (TSH), Triiodothyronine (T3) and Thyroxin (T4) on the activity level of the vitamin K-dependent plasma factors of blood coagulation--factor II (F II), factor VII (F VII), factor IX (F IX) and factor X (F X). This study was carried out on 40 male Wistar rats. The necessary quantity of blood was obtained by cardiac puncture under ether narcosis. The indicators studied were activated partial thromboplastin time (aPTT), protothrombin time (PT), F II, F VII, F IX and F X, and were determined by means of Diagnostica Stago tests and with the help of an automatic coagulometer. The hormones studied were: TRH (0.06 mg/kg b.w.), TSH (1 MU/kg b.w.), T3 (0.08 mg/kg b.w.) T4 (0.08 mg/kg b.w.) prolonged aPTT (p<0.001) and PT (p<0.001). TRH and T3 significantly reduced the activity level of factors II, VII, IX and X; T4 only reduced the level of F II (p<0.05), and TSH did not induce significant changes in the haemocoagulation factors studied. The TRH, TSH, T3 and T4 hormones, although elements of one and the same axis, have an ambiguous effect on the vitamin K-dependent factors of blood coagulation. The results obtained show that the determined changes in the activity levels of the vitamin K-dependent plasma factors of blood coagulation are undoubtedly related to the hypocoagulation observed in the intrinsic and extrinsic pathways under the influence of the hormones of the thyroid axis.

Key Clinical MessageAs Rosai–Dorfman Disease presents generally nonspecific symptoms, differential diagnosis can be of great learning curve for physicians. Additionally, RDD does not usually threaten life and spontaneous remission is frequently observed. However, unusually in our case the patient passed away within 1 month of confirmed diagnosis.

The hormones of the hypothalamic-pituitary-thyroid axis exert various effects in organism, but their influence on the functional activity of platelets is relatively unknown. To establish the effect of the hormones of the hypothalamic-pituitary-thyroid axis on the functional activity of platelets by means of determining the plasma level of beta-thromboglobulin (β-TG) and platelet factor 4 (PF4) a study was conducted on 40 white male rats of the “Wistar” breed. The necessary blood volume was obtained under ether narcosis by cardiac puncture in CTAD-test-tubes. Using Diagnostica Stago (France) tests, by means of enzyme-immune test, the level of two of the most informative platelet secretion markers was determined. The hormones: Thyreotropin releasing hormone (0.06 mg/kg bw), Thyroid stimulating hormone (1 MU/kg bw), Trijodthyroninum (0.08 mg/kg bw), Thyroxin (0.08 mg/kg bw), applied s.c. on three consecutive days strongly reduce the plasma level of β-TG (p<0.001) and PF 4 (p < 0.001). The reduced level of β-TG and PF 4 in the plasma is an indicator of their reduced functional activity, which is one of the determinants for the development of hemocoagulation. The functional activity of platelets in rats, determined by the level of β-TG and PF 4, is significantly suppressed by all hormones of the hypothalamic-pituitary-thyroid axis.